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Grey E, Griffin T, Jolly K, Pallan M, Parretti H, Retzer A, Gillison F. Extended brief interventions for weight management and obesity prevention in children: A rapid evidence review. Obes Rev 2023; 24:e13633. [PMID: 37604189 DOI: 10.1111/obr.13633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 07/25/2023] [Accepted: 07/30/2023] [Indexed: 08/23/2023]
Abstract
Uptake of child weight management (CWM) support is typically low, and services are not available in all areas. Extended brief interventions (EBIs) have been proposed as an affordable way to provide enhanced support, at a level between one-off brief advice and intensive CWM programs. This rapid systematic review sought to synthesize evidence on the efficacy of EBIs for weight management and obesity prevention in children (2-18 years). Embase and Web of Science were searched from January 2012 to January 2022. Nineteen studies, reporting on 17 separate EBIs, were included. The quality of studies was variable, and the EBIs were heterogeneous. The majority of EBIs (n = 14) were based on motivational interviewing. Five of the included studies reported significant improvements in parent or child determinants of health behavior change. However, robust measures of behavioral determinants were rarely used. No studies reported significant positive effects on child weight. No clear patterns in outcomes were identified. There is currently insufficient evidence for EBIs to be adopted as part of CWM services. To improve the evidence base, EBIs that are currently being implemented by local health services, should be evaluated to establish the most effective content, how it should be delivered, and by whom.
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Affiliation(s)
- Elisabeth Grey
- NIHR Applied Research Collaboration West, Bristol Medical School, University of Bristol, Bristol, UK
- Department for Health, University of Bath, Bath, UK
| | | | - Kate Jolly
- Institute of Applied Health Research and NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
| | - Miranda Pallan
- Institute of Applied Health Research and NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
| | - Helen Parretti
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ameeta Retzer
- Institute of Applied Health Research and NIHR Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
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Chan J, Conroy P, Phongsavan P, Raubenheimer D, Allman-Farinelli M. Systems map of interventions to improve dietary intake of pre-school aged children: A scoping review. Prev Med 2023; 177:107727. [PMID: 37848165 DOI: 10.1016/j.ypmed.2023.107727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/19/2023]
Abstract
Implementation and sustaining impact of early childhood nutrition interventions in practice remains a challenge. An understanding of the extent to which determinants across multiple levels of the food system are being addressed may improve success. This literature review aimed to synthesise the evidence on interventions targeting dietary intake and eating behaviours in preschool children using a systems approach. Eligible studies included intervention studies targeting the dietary intake of preschool children aged 2-5 years in high income countries, published in English after January 2000. Interventions were categorised to the Determinants of Nutrition and Eating (DONE) framework for children developed and evaluated by experts across multiple fields. The framework maps and ranks 411 factors driving eating behaviours and nutrition and can be used to systematically summarise determinants. DONE ranks each determinant for its perceived research priority. A total of 160 eligible studies were identified. Most interventions targeted interpersonal (n = 101, 63.1%) and individual (n = 85, 53.1%) level determinants, with fewer targeting environmental (n = 55, 34.4%) and policy level (n = 17, 10.6%) determinants. The most frequently addressed determinants were Parental Resources and Risk Factors (n = 85) and Children's Food Knowledge, Skills and Abilities (n = 67). These determinants had a Moderate research priority rating. Home Food Availability and Accessibility at the environmental level is classified as the highest research priority, however, only 15 of 160 interventions addressed this determinant. This review highlights home food availability and accessibility as potential leverage points for future interventions to improve children's dietary intake and eating behaviours.
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Affiliation(s)
- Jacqueline Chan
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.
| | - Patrick Conroy
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Philayrath Phongsavan
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia; Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - David Raubenheimer
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia; School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman-Farinelli
- Nutrition and Dietetics Group, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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Moss S, Gu X. Home- and Community-Based Interventions for Physical Activity and Early Child Development: A Systematic Review of Effective Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911968. [PMID: 36231271 PMCID: PMC9565703 DOI: 10.3390/ijerph191911968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 06/09/2023]
Abstract
This systematic review examined the effects of home/family and community-based interventions on physical activity (PA) and developmental outcomes in early childhood. A search strategy was employed using four electronic databases (Academic Search Complete, CINAHL Complete, MEDLINE, and SPORTDiscus). Interventions investigating weight status (i.e., BMI), physical activity, sedentary behavior, and/or motor proficiency that took place in home, family, or community settings were assessed. Studies were eligible if they were peer-reviewed, available in English, published between 2011 and 2021, and if samples consisted of healthy young children (2-5 years old). There were 24 studies retained (8351 participants) spanning from the United States (n = 12), Australia (n = 3), Canada (n = 2), Switzerland (n = 2), Finland (n = 2), Netherlands (n = 1), and other Eastern European countries (n = 2). There were 19 studies that incorporated home/family-based approaches and 14 studies that incorporated community-based approaches. Studies ranged in intervention duration from 6 weeks to 24 months. It suggests that improving PA participation in young children was especially challenging to solicit improvement (only 25% of all studies found significant improvement in PA after intervention). Distributing educational material to parents/families, consistent, direct contact with parents, and encouraging community engagement were identified as effective strategies to promote physical activity, healthy weight status, and motor skills in young children.
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Affiliation(s)
- Samantha Moss
- Department of Kinesiology, State University of New York at Cortland, Cortland, NY 13090, USA
| | - Xiangli Gu
- Department off Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA
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Systematic review of parental influences on Hispanic children's nutritional and physical health. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01713-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Luo M, Allman-Farinelli M. Trends in the Number of Behavioural Theory-Based Healthy Eating Interventions Inclusive of Dietitians/Nutritionists in 2000-2020. Nutrients 2021; 13:nu13114161. [PMID: 34836417 PMCID: PMC8623843 DOI: 10.3390/nu13114161] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/06/2021] [Accepted: 11/10/2021] [Indexed: 01/08/2023] Open
Abstract
Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications related to healthy eating interventions that used behaviour change theories. Interventional studies published in English between 2000 and 2020 were retrieved from searching Medline, Cinahl, Embase, Psycinfo and Cochrane Central. Citation, country of origin, presence or absence of dietitian/nutritionist authors, participants, dietary behaviours, outcomes, theories and any behaviour change techniques (BCTs) stated were extracted. The publication trends on a yearly basis were recorded. A total of 266 articles were included. The number of theory-based interventions increased over the two decades. The number of studies conducted by dietitians/nutritionists increased, but since 2012, increases have been driven by other researchers. Social cognitive theory was the most used behaviour theory. Dietitians/nutritionists contributed to growth in publication of theory-based healthy eating interventions, but the proportion of researchers from other professions engaged in this field increased markedly. The reasons for this growth in publications from other professions is unknown but conjectured to result from greater prominence of dietary behaviours within the context of an obesity epidemic.
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Affiliation(s)
- Man Luo
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia;
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310020, China
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia;
- Correspondence: ; Tel.: +61-2-90367045
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Jiang Q, Tovar A, Risica PM, Cooksey Stowers K, Schwartz M, Lombardi C, Kang A, Mena NZ, Gans KM. Ethnic Differences in Family Childcare Providers' Nutrition- and Activity-Related Attitudes and Barriers. J Obes 2021; 2021:6697006. [PMID: 34659829 PMCID: PMC8516587 DOI: 10.1155/2021/6697006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/07/2021] [Accepted: 09/21/2021] [Indexed: 11/25/2022] Open
Abstract
Objective The aim of the study is to examine family childcare providers' (FCCPs) attitudes and perceived barriers related to nutrition, physical activity (PA), and screen time (ST) behaviors of preschool children, exploring differences by provider ethnicity. Design Baseline survey data from a cluster-randomized trial. Participants. Around 168 FCCPs completed a telephone survey, and 126 completed both telephone and in-person surveys. Main Outcome Measures. Phone and in-person surveys include 44 questions to assess FCCPs attitudes and perceived barriers regarding nutrition, PA, and ST in the family childcare home. Analysis. Associations by ethnicity (Latinx vs. non-Latinx) were assessed by ANOVA, adjusting for provider education and Bonferroni correction. Results Some FCCP attitudes were consistent with national obesity prevention guidelines; for example, most FCCPs agreed that they have an important role in shaping children's eating and PA habits. However, many FCCPs agreed with allowing children to watch educational TV and did not agree that children should serve themselves at meals. Adjusting for education, there were statistically significant differences in attitude and perceived barrier scores by provider ethnicity. For example, Latinx FCCPs were more likely to agree that they should eat the same foods as children(p < .001) but less likely to agree that serving the food at meal and snack time is the adult's responsibility (p < .001). Latinx FCCPs were more like to perceive barriers related to children's safety playing outside (p < .001). Conclusions and Implications. While FCCPs hold some nutrition-, PA-, and ST-related attitudes consistent with national guidelines, training opportunities are needed for FCCPs to improve knowledge and skills and overcome perceived barriers related to nutrition and PA. Latinx FCCPs, in particular, may need culturally tailored training and support to overcome misperceptions and barriers.
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Affiliation(s)
- Qianxia Jiang
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Patricia M. Risica
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA
| | - Kristen Cooksey Stowers
- University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- University of Connecticut Rudd Center for Food Policy and Obesity, Hartford, CT, USA
| | - Marlene Schwartz
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
- University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA
- University of Connecticut Rudd Center for Food Policy and Obesity, Hartford, CT, USA
| | - Caitlin Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Augustine Kang
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Noereem Z. Mena
- Food Science and Human Nutrition Department, Colorado State University, Fort Collins, CO, USA
| | - Kim M. Gans
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
- Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
- University of Connecticut Institution for Collaboration in Health, Interventions and Policy, Storrs, CT, USA
- University of Connecticut Rudd Center for Food Policy and Obesity, Hartford, CT, USA
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Jones A, Armstrong B, Weaver RG, Parker H, von Klinggraeff L, Beets MW. Identifying effective intervention strategies to reduce children's screen time: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2021; 18:126. [PMID: 34530867 PMCID: PMC8447784 DOI: 10.1186/s12966-021-01189-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/12/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Excessive screen time ([Formula: see text] 2 h per day) is associated with childhood overweight and obesity, physical inactivity, increased sedentary time, unfavorable dietary behaviors, and disrupted sleep. Previous reviews suggest intervening on screen time is associated with reductions in screen time and improvements in other obesogenic behaviors. However, it is unclear what study characteristics and behavior change techniques are potential mechanisms underlying the effectiveness of behavioral interventions. The purpose of this meta-analysis was to identify the behavior change techniques and study characteristics associated with effectiveness in behavioral interventions to reduce children's (0-18 years) screen time. METHODS A literature search of four databases (Ebscohost, Web of Science, EMBASE, and PubMed) was executed between January and February 2020 and updated during July 2021. Behavioral interventions targeting reductions in children's (0-18 years) screen time were included. Information on study characteristics (e.g., sample size, duration) and behavior change techniques (e.g., information, goal-setting) were extracted. Data on randomization, allocation concealment, and blinding was extracted and used to assess risk of bias. Meta-regressions were used to explore whether intervention effectiveness was associated with the presence of behavior change techniques and study characteristics. RESULTS The search identified 15,529 articles, of which 10,714 were screened for relevancy and 680 were retained for full-text screening. Of these, 204 studies provided quantitative data in the meta-analysis. The overall summary of random effects showed a small, beneficial impact of screen time interventions compared to controls (SDM = 0.116, 95CI 0.08 to 0.15). Inclusion of the Goals, Feedback, and Planning behavioral techniques were associated with a positive impact on intervention effectiveness (SDM = 0.145, 95CI 0.11 to 0.18). Interventions with smaller sample sizes (n < 95) delivered over short durations (< 52 weeks) were associated with larger effects compared to studies with larger sample sizes delivered over longer durations. In the presence of the Goals, Feedback, and Planning behavioral techniques, intervention effectiveness diminished as sample size increased. CONCLUSIONS Both intervention content and context are important to consider when designing interventions to reduce children's screen time. As interventions are scaled, determining the active ingredients to optimize interventions along the translational continuum will be crucial to maximize reductions in children's screen time.
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Affiliation(s)
- Alexis Jones
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - R. Glenn Weaver
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Hannah Parker
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Lauren von Klinggraeff
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - M. W. Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
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Weiss-Laxer NS, Crandall A, Hughes ME, Riley AW. Families as a Cornerstone in 21st Century Public Health: Recommendations for Research, Education, Policy, and Practice. Front Public Health 2020; 8:503. [PMID: 33072687 PMCID: PMC7530559 DOI: 10.3389/fpubh.2020.00503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/06/2020] [Indexed: 11/16/2022] Open
Abstract
Families are vastly overlooked in US initiatives to promote population health and health equity despite being the most proximal context for health across the life course. We urge the public health sector to take the lead in recognizing families as essential for promoting 21st century population health. We highlight ways families influence health by providing context, care, continuity, and connections. The dual private and public aspect of families has contributed to how they have been overlooked in the public health sector. We provide recommendations for better integrating families into population health initiatives through national health goals, research, education, policy, and practice.
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Affiliation(s)
- Nomi S Weiss-Laxer
- Department of Family Medicine, Primary Care Research Institute, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - AliceAnn Crandall
- Department of Public Health, Brigham Young University, Provo, UT, United States
| | - Mary Elizabeth Hughes
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Anne W Riley
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Racial Differences in Perceived Food Swamp and Food Desert Exposure and Disparities in Self-Reported Dietary Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197143. [PMID: 33003573 PMCID: PMC7579470 DOI: 10.3390/ijerph17197143] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 01/24/2023]
Abstract
Both food swamps and food deserts have been associated with racial, ethnic, and socioeconomic disparities in obesity rates. Little is known about how the distribution of food deserts and food swamps relate to disparities in self-reported dietary habits, and health status, particularly for historically marginalized groups. In a national U.S. sample of 4305 online survey participants (age 18+), multinomial logistic regression analyses were used to assess by race and ethnicity the likelihood of living in a food swamp or food desert area. Predicted probabilities of self-reported dietary habits, health status, and weight status were calculated using the fitted values from ordinal or multinomial logistic regression models adjusted for relevant covariates. Results showed that non-Hispanic, Black participants (N = 954) were most likely to report living in a food swamp. In the full and White subsamples (N = 2912), the perception of residing in a food swamp/desert was associated with less-healthful self-reported dietary habits overall. For non-Hispanic Blacks, regression results also showed that residents of perceived food swamp areas (OR = 0.66, p < 0.01, 95% CI (0.51, 0.86)) had a lower diet quality than those not living in a food swamp/food desert area. Black communities in particular may be at risk for environment-linked diet-related health inequities. These findings suggest that an individual's perceptions of food swamp and food desert exposure may be related to diet habits among adults.
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Fox K, Gans K, McCurdy K, Risica PM, Jennings E, Gorin A, Papandonatos GD, Tovar A. Rationale, design and study protocol of the 'Strong Families Start at Home' feasibility trial to improve the diet quality of low-income, ethnically diverse children by helping parents improve their feeding and food preparation practices. Contemp Clin Trials Commun 2020; 19:100583. [PMID: 32637721 PMCID: PMC7327278 DOI: 10.1016/j.conctc.2020.100583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/18/2020] [Accepted: 06/07/2020] [Indexed: 12/28/2022] Open
Abstract
There is an urgent need to create effective interventions that help parents establish a healthy diet among their children early in life, especially among low-income and ethnically and racially diverse families. U.S. children eat too few fruits, vegetables and whole grains, and too many energy dense foods, dietary behaviors associated with increased morbidity from chronic diseases. Parents play a key role in shaping children's diets. Best practices suggest that parents should involve children in food preparation, and offer, encourage and model eating a variety of healthy foods. In addition, while parents help to shape food preferences, not all children respond in the same way. Certain child appetitive traits, such as satiety responsiveness (sensitivity to internal satiety signals), food responsiveness (sensitivity to external food cues), and food fussiness may help explain some of these differences. Prior interventions to improve the diet of preschool children have not used a holistic approach that targets the home food environment, by focusing on food quality, food preparation, and positive feeding practices while also acknowledging a child's appetitive traits. This manuscript describes the rationale and design for a 6-month pilot randomized controlled trial, Strong Families Start at Home, that randomizes parents and their 2-to 5-year old children to either a home-based environmental dietary intervention or an attention-control group. The primary aim of the study is to explore the feasibility and acceptability of the intervention and evaluation and to determine the intervention's preliminary efficacy on child diet quality, feeding practices, and availability of healthy foods in the home.
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Affiliation(s)
- Katelyn Fox
- Department of Nutrition and Food Science, University of Rhode Island, 41 Lower College Road, Room 125, Kingston, RI, 02881, USA
| | - Kim Gans
- Department of Human Development and Family Studies, and Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Karen McCurdy
- Department of Human Development & Family Studies, University of Rhode Island, Kingston, RI, USA
| | - Patricia Markham Risica
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Ernestine Jennings
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - Amy Gorin
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | | | - Alison Tovar
- Department of Nutrition and Food Science, University of Rhode Island, Kingston, RI, USA
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Innella N, Jameson BE. Interventions that impact weight status in Hispanic preschool children. Public Health Nurs 2019; 37:25-38. [PMID: 31633235 DOI: 10.1111/phn.12677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objectives of this systematic review of literature include: (a) describe the intervention strategies; (b) examine the outcomes as they pertain to the child (individual level), families (interpersonal level), and community or culture (organizational level); and (c) develop a foundation of interventional approaches that specifically target obesogenic behaviors in Hispanic preschool-aged children. DESIGN A systematic review of literature was performed. The theoretical framework was the Socioecological Model. SAMPLE Twenty-four total articles were used for this review. MEASUREMENTS The method used was the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Of the 24 studies reviewed, 36% focused on the individual, 56% were interpersonal (focused on parents), and 9% focused on the organizational level. CONCLUSION Interventions that are culturally competent, directed at families, and include healthy dietary intake along with a physical activity component are most effective at lowering obesity in Hispanic preschool children.
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Risica PM, Tovar A, Palomo V, Dionne L, Mena N, Magid K, Ward DS, Gans KM. Improving nutrition and physical activity environments of family child care homes: the rationale, design and study protocol of the 'Healthy Start/Comienzos Sanos' cluster randomized trial. BMC Public Health 2019; 19:419. [PMID: 30999881 PMCID: PMC6472069 DOI: 10.1186/s12889-019-6704-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 03/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early childhood is a crucial time to foster healthy eating and physical activity (PA) habits, which are critical for optimal child health, growth and development. Child care facilities are important settings to promote healthy eating and PA and prevent childhood obesity; however, almost all prior intervention studies have focused on child care centers and not family child care homes (FCCH), which care for over 1.6 million U.S. children. METHODS This paper describes Healthy Start/Comienzos Sanos, a cluster-randomized trial evaluating the efficacy of a multicomponent intervention to improve nutrition and PA environments in English and Spanish-speaking FCCH. Eligible child care providers complete baseline surveys and receive a two-day FCCH observation of the home environment and provider practices. Parent-consented 2-5 year-old children are measured (height, weight, waist circumference), wear accelerometers and have their dietary intake observed during child care using validated protocols. FCCH providers are then randomly assigned to receive an 8-month intervention including written materials tailored to the FCCH providers' need and interest, videos, peer support coaching using brief motivational interviewing, and periodic group meetings focused on either nutrition and PA (Intervention) or reading readiness (Comparison). Intervention materials focus on evidence-based nutrition and physical activity best practices. The initial measures (surveys, two-day observation of the FCCH and provider practices, child diet observation, physical measures, and accelerometer) are assessed again 8 and 12 months after the intervention starts. Primary outcomes are children's diet quality (Healthy Eating Index), time in moderate and vigorous PA and sedentary PA during child care. Secondary outcomes include FCCH provider practices and foods served, and PA environments and practices. Possible mediators (provider attitudes, self-efficacy, barriers and facilitators) are also being explored. Process evaluation measures to assess reach, fidelity and dose, and their relationship with dietary and PA outcomes are included. DISCUSSION Healthy Start/Comienzos Sanos fills an important gap in the field of childhood obesity prevention by rigorously evaluating an innovative multicomponent intervention to improve the nutrition and physical activity environments of FCCH. TRIAL REGISTRATION (# NCT02452645 ) ClinicalTrials.gov Trial registered on May 22, 2015.
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Affiliation(s)
- Patricia Markham Risica
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI 02912 USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912 USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881 USA
| | - Vanessa Palomo
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI 02912 USA
| | - Laura Dionne
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI 02912 USA
| | - Noereem Mena
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881 USA
| | - Kate Magid
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912 USA
| | - Diane Stanton Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7461 USA
| | - Kim M. Gans
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI 02912 USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912 USA
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269 USA
- Institute for Collaboration in Health, Interventions and Policy, University of Connecticut, Storrs, CT 06269 USA
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Franzen-Castle L, Colby SE, Kattelmann KK, Olfert MD, Mathews DR, Yerxa K, Baker B, Krehbiel M, Lehrke T, Wilson K, Flanagan SM, Ford A, Aguirre T, White AA. Development of the iCook 4-H Curriculum for Youth and Adults: Cooking, Eating, and Playing Together for Childhood Obesity Prevention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:S60-S68. [PMID: 30851862 DOI: 10.1016/j.jneb.2018.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/02/2018] [Accepted: 11/06/2018] [Indexed: 06/09/2023]
Abstract
The objective was to describe the development process of a curriculum (iCook 4-H) targeted to low-income, rural, and/or diverse youths and their adult primary meal preparer to promote cooking, eating, and playing together. Lessons learned highlighted the importance of grounding the curriculum in Social Cognitive Theory and applying the experiential 4-H learning model using a multiphased, community-based participatory approach with cyclical development and evaluation, and key modifications made for dissemination and distribution. Findings across 4 testing phases over 6 years and 5 states demonstrated the time-intensive, cyclical process that required flexibility with fidelity to form a hands-on, interactive curriculum.
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Affiliation(s)
- Lisa Franzen-Castle
- Nutrition and Health Sciences Department, University of Nebraska-Lincoln, Lincoln, NE.
| | - Sarah E Colby
- Department of Nutrition, University of Tennessee, Knoxville, TN
| | - Kendra K Kattelmann
- Department of Health and Nutritional Sciences, South Dakota State University, Brookings, SD
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources and Design, West Virginia University, Morgantown, WV
| | | | - Kathryn Yerxa
- School of Food and Agriculture, University of Maine Cooperative Extension, Orono, ME
| | - Barbara Baker
- 4-H Youth Development, University of Maine Cooperative Extension, Bangor, ME
| | | | - Tracey Lehrke
- Roberts County, South Dakota State University, Sisseton, SD
| | - Kimberly Wilson
- Family and Community Health, South Dakota State University, Brookings, SD
| | | | - Amber Ford
- Department of Nutrition, University of Tennessee, Knoxville, TN
| | - Trina Aguirre
- College of Nursing-Western Nebraska Division, University of Nebraska Medical Center, Scottsbluff, NE
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Mirotta JA, Darlington GA, Buchholz AC, Haines J, Ma DW, Duncan AM. Guelph Family Health Study’s Home-Based Obesity Prevention Intervention Increases Fibre and Fruit Intake in Preschool-Aged Children. CAN J DIET PRACT RES 2018; 79:86-90. [DOI: 10.3148/cjdpr-2017-036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: The Guelph Family Health Study (GFHS) pilot was designed to examine the feasibility and effectiveness of a home-based obesity prevention intervention on health behaviours and obesity risk. The objective of this analysis was to determine the effect of the 6-month intervention on preschool-aged children’s dietary intakes. Methods: Families with children aged 1.5–5 years old were randomized to receive one of the following: 4 home visits with a health educator as well as tailored emails and mailed incentives (4HV; n = 19 children); 2 home visits with a health educator as well as tailored emails and mailed incentives (2HV; n = 14 children); or general health advice through emails (control; n = 12 children). Three-day food records were completed by parents for their children before and after the 6-month intervention and analyzed for 3-day average intakes of energy, nutrients, and MyPlate food groups. Results: After the 6-month intervention, the 4HV group had significantly higher fibre intake and the 4HV and 2HV groups had significantly higher fruit intake, both compared with the control group. Conclusions: This study provides support for a home-based intervention approach to improve the diet quality of preschool-aged children.
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Affiliation(s)
- Julia A. Mirotta
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | | | - Andrea C. Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
| | - David W.L. Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Alison M. Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
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Touyz L, Cohen J, Wakefield C, Grech A, Garnett S, Gohil P, Cohn R. Design and Rationale for a Parent-Led Intervention to Increase Fruit and Vegetable Intake in Young Childhood Cancer Survivors (Reboot): Protocol for a Pilot Study. JMIR Res Protoc 2018; 7:e129. [PMID: 29769170 PMCID: PMC5976864 DOI: 10.2196/resprot.9252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Poor dietary habits are common among childhood cancer survivors, despite increasing their risk of cardio metabolic complications after cancer treatment. Here, we describe the design and rationale for a pilot telephone-based, parent-led intervention aimed at increasing fruit and vegetable intake in young cancer survivors (Reboot). OBJECTIVE This pilot study aims to assess the feasibility and acceptability of delivering evidence-based telephone support to parents of childhood cancer survivors. A secondary aim includes assessing the effect of Reboot on improving childhood cancer survivors' dietary quality by increasing child fruit and vegetable intake and variety and its contribution to overall nutrient intake. METHODS We aim to recruit parents of 15 young cancer survivors aged 2 to 12 years who have completed cancer treatment less than five years ago. The intervention comprises of 4 weekly 45-minute telephone sessions led by a health professional and one booster session 6 weeks later. Sessions address the effects of cancer treatment on children's diets, recommended fruit and vegetable intake for children, and evidence-based strategies to promote the consumption of fruit and vegetables as well as to manage fussy eating. RESULTS Reboot is based on an existing, evidence-based parent nutrition intervention and modified for childhood cancer survivors following extensive collaboration with experts in the field. Primary outcomes of feasibility and acceptability will be measured by the number of participants who complete all five sessions, average session length (minutes), length between sessions (days) and parent Likert ratings of the usefulness and impact of the intervention collected after the booster session. Of the 15 participants we aim to recruit, 3 have completed the intervention, 1 declined to participate, 11 are actively completing the intervention and 2 participants are providing written consent. The remaining 3 participants will be recruited via telephone follow-up calls. The intervention is due to be completed by July 2018. CONCLUSIONS Reboot aims to support healthy dietary behaviors in childhood cancer survivors who are at increased risk of developing serious cardiometabolic complications after their cancer treatment. Results will inform the development and implementation of future evidence-based dietary interventions delivered to childhood cancer survivors, particularly those living in rural and remote areas. REGISTERED REPORT IDENTIFIER RR1-10.2196/9252.
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Affiliation(s)
- Lauren Touyz
- Behavioural Sciences Unit, Kids Cancer Centre, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, Australia
| | - Jennifer Cohen
- Behavioural Sciences Unit, Kids Cancer Centre, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, Australia
| | - Claire Wakefield
- Behavioural Sciences Unit, Kids Cancer Centre, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, Australia
| | - Allison Grech
- Behavioural Sciences Unit, Kids Cancer Centre, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, Australia
| | - Sarah Garnett
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia
| | - Paayal Gohil
- Behavioural Sciences Unit, Kids Cancer Centre, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, Australia
| | - Richard Cohn
- Behavioural Sciences Unit, Kids Cancer Centre, School of Women's and Chidlren's Health, University of New South Wales Sydney, Sydney, Australia
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Taverno Ross SE, Barone Gibbs B, Documet PI, Pate RR. ANDALE Pittsburgh: results of a promotora-led, home-based intervention to promote a healthy weight in Latino preschool children. BMC Public Health 2018; 18:360. [PMID: 29548321 PMCID: PMC5857096 DOI: 10.1186/s12889-018-5266-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 03/07/2018] [Indexed: 11/11/2022] Open
Abstract
Background Latino preschool children have higher rates of obesity than preschool children from other racial/ethnic groups; however, few effective, culturally appropriate interventions exist targeting this group. The purpose of this study was to test the feasibility of a 10-week, promotora-mediated, home-based intervention to promote a healthy weight in Latino preschool children. Methods Trained promotoras (community health workers) delivered 10, 90-min weekly interactive and tailored sessions to Latino families living in Allegheny County. Participants were recruited through promotoras’ own social networks and community gatherings, flyers, and word of mouth. Primary outcome measures included child body mass index (BMI) z-score and percentile. Secondary outcome measures included child objectively measured physical activity and dietary intake, and the home social and physical environment (e.g., parent health behaviors, parent self-efficacy, parental support, physical activity equipment in the home). The final analysis sample included 49 of 51 participants who completed both baseline and follow-up assessments. Results Participants included mothers (33.5 ± 6.1 years old) and their preschool-aged children who were primarily 1st generation immigrants from Mexico (65%). The primary analyses of BMI percentile and z-score showed no change post-intervention. However, there was a significant decrease in child BMI percentile for overweight and obese children from baseline to follow-up (p < .05). We also saw significant pre/post increases in child daily fruit and vegetable intake, and parent moderate-to-vigorous physical activity, fruit and vegetable servings per day, and self-efficacy; and significant decreases in child saturated fat and added-sugar intake, and child and parent screen time (p’s < .05). Conclusions Despite the short duration of the intervention and follow-up, this pilot study showed promising effects of a promotora-mediated intervention to promote a healthy weight in Latino preschool children. Electronic supplementary material The online version of this article (10.1186/s12889-018-5266-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sharon E Taverno Ross
- Department of Health and Physical Activity, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, 15261, USA.
| | - Bethany Barone Gibbs
- Department of Health and Physical Activity, University of Pittsburgh, 32 Oak Hill Court, Pittsburgh, PA, 15261, USA
| | - Patricia I Documet
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, 921 Assembly Street, Columbia, SC, 29208, USA
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Essel KD, Yalamanchi S, Hysom E, Lichtenstein C. Healthy Homes, Healthy Futures: A Home Visitation Curriculum for Pediatric Residents. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2016; 12:10480. [PMID: 30984822 PMCID: PMC6440495 DOI: 10.15766/mep_2374-8265.10480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 07/26/2016] [Indexed: 06/02/2023]
Abstract
INTRODUCTION A working knowledge of the home and neighborhood environment is critical to understanding the barriers that families face when struggling with obesity. Most doctors are only given the opportunity to address individuals with obesity in the office setting and usually describe their counseling abilities as ineffective. This focused home visitation curriculum offers a unique tool to improve residents' understanding of the social determinants of health, how these determinants relate to obesity, and critical obesity-management skills. METHODS The curriculum requires residents to review three PowerPoint modules and an article on motivational interviewing. Residents then implement what they have learned by doing two home visits with a family from their continuity clinic and completing a windshield survey of the family's neighborhood. This publication includes all of the materials necessary to facilitate the curriculum, including scripts for the residents to use at each visit, resources for the family, and curriculum evaluation tools. RESULTS Twenty residents who completed the curriculum reported improved counseling skills and improved understanding of the social determinants of health. During postcurriculum qualitative interviews, residents described the experience as eye-opening and revealed that lessons learned from the visits will alter how they approach patients who are obese in their future clinical practice. DISCUSSION The program has been integrated into our pediatric residency curriculum and completed during a first-year community health rotation, but it could be completed at any time during resident training.
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Affiliation(s)
- Kofi D. Essel
- General Academic Pediatric Fellow, Department of General and Community Pediatrics, Children's National Health System
| | - Sirisha Yalamanchi
- Pediatric Critical Care Fellow, Department of Pediatrics, Columbia University Medical Center
| | - Erin Hysom
- Coordinator of Select Education Initiatives & Effectiveness, Department of the Office of School and Community Nutrition Programs, Maryland State Department of Education
| | - Cara Lichtenstein
- Assistant Professor of Pediatrics, Department of General and Community Pediatrics, Children's National Health System
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Soto SC, Arredondo EM, Horton LA, Ayala GX. Validation of the modified Parenting Strategies for Eating and Physical Activity Scale-Diet (PEAS-Diet) in Latino children. Appetite 2016; 98:55-62. [DOI: 10.1016/j.appet.2015.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 12/01/2015] [Accepted: 12/03/2015] [Indexed: 01/18/2023]
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